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  • Two research teams in China have developed new local therapy approaches that are designed to eliminate brain tumour cells while minimizing damage to the surrounding healthy tissue.

    • Heather Wood
    Research Highlight
  • A phase II trial of the tau antibody semorinemab indicates that it has no clinical benefit in the earliest stages of Alzheimer disease. The repeated finding that antibody-mediated reductions in protein pathology have limited or no clinical benefit indicates that we need to consider more specific or combined therapeutic targets.

    • Francesco Panza
    • Madia Lozupone
    News & Views
  • In this Review, the authors provide detailed insight into how the gut microbiota influences the immune system, with implications for neuroinflammation, and discuss the accumulating evidence that the gut microbiota is an important factor in multiple sclerosis pathogenesis and a potential therapeutic target.

    • Jorge Correale
    • Reinhard Hohlfeld
    • Sergio E. Baranzini
    Review Article
  • Cognitive rehabilitation is a promising approach to limit the effect of cognitive impairment on patients with multiple sclerosis, although results so far are conflicting. A new study indicates that structural and functional MRI techniques could provide reliable measures to predict treatment responses and tailor the rehabilitative approach to each patient.

    • Massimo Filippi
    • Paolo Preziosa
    News & Views
  • This Review considers how variants in genes encoding proteins that regulate epigenetic mechanisms might contribute to epilepsy. The discussion is structured around five categories of epigenetic mechanisms: DNA methylation, histone modifications, histone–DNA crosstalk, non-coding RNAs and chromatin remodelling.

    • Karen M. J. Van Loo
    • Gemma L. Carvill
    • David C. Henshall
    Review Article
  • In this Roadmap, Marrie and colleagues set out the steps needed to improve our understanding of the multiple sclerosis (MS) prodrome and develop standardized criteria for identifying individuals with prodromal MS, thereby facilitating trials of interventions that could slow progression to classical MS.

    • Ruth Ann Marrie
    • Mark Allegretta
    • Helen Tremlett
    Roadmap
  • A new longitudinal study involving carriers of amyotrophic lateral sclerosis (ALS)-associated mutations has identified a prodromal phase of ALS characterized by mild motor impairment. The findings could help us to define a time window during which neuroprotective interventions might be effective in patients with genetic forms of ALS.

    • Mamede de Carvalho
    News & Views
  • Low-resource settings lag behind the rest of the world in achieving good health, in part owing to poor translation of clinical evidence into practice. Focusing on neurological disorders — in particular, stroke — this Comment identifies barriers to translation at the individual, provider and health systems levels and proposes theory-driven mitigating solutions.

    • Mayowa O. Owolabi
    • Nijasri C. Suwanwela
    • Joseph Yaria
    Comment
  • Effective translation of evidence from clinical trials into clinical practice requires the enrolment of diverse, representative trial populations. However, this diversity is still often lacking, with negative clinical implications for under-served groups. Changes are needed to research practices and the broader research landscape to correct this problem.

    • Lynn Rochester
    • Camille Carroll
    Comment
  • The past 5–10 years have seen rapid advances in digital sensors and imaging-based technologies for the diagnosis of neurological conditions. However, the majority of these technologies are in the early stages of development — now is the time to consider how we validate these tools and safely integrate them into clinical practice.

    • Cristina Granziera
    • Tim Woelfle
    • Ludwig Kappos
    Comment
  • A growing number of clinical practice guidelines are being developed for neurological diseases, and they have the potential to benefit patients, clinicians, policymakers and payers. However, the effectiveness of these guidelines has not been evaluated, so we do not yet know whether they improve patient outcomes in a real-world setting.

    • Maurizio A. Leone
    • Joao Costa
    Comment